NPIMap

Organization Active NPI

Promedica Central Physicians LLC

  • Surgery Physician
  • Oregon, OH
National Provider Identifier
1588091599
Registry record updated Oct 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
PROMEDICA CENTRAL PHYSICIANS LLC
Practice address
2751 Bay Park Dr
Suite 202
Oregon, OH 43616-4921
Phone
(419) 690-7550
Fax
(419) 697-7919
NPI assigned
Oct 4, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Amy L Dywer
Title
Credentialing Supervisor
Phone
(419) 824-7334

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X OH Primary
Colon & Rectal Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208C00000X OH

Addresses

Primary practice location

2751 Bay Park Dr
Suite 202
Oregon, OH 43616-4921

Mailing address

2751 Bay Park Dr
Suite 202
Oregon, OH 43616-4921
Phone (419) 690-7550

Other names 1

  • Bay Park Surgical Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Promedica Central Physi75 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

2751 Bay Park Dr
Ste 202
Oregon, OH 43616
Phone (419) 690-7550

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1380844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380844800000",
    "number": "1588091599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2751 BAY PARK DR",
            "address_2": "SUITE 202",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436164921",
            "telephone_number": "419-690-7550",
            "fax_number": "419-697-7919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2751 BAY PARK DR",
            "address_2": "SUITE 202",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436164921",
            "telephone_number": "419-690-7550",
            "fax_number": "419-697-7919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMEDICA CENTRAL PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-04",
        "last_updated": "2013-10-04",
        "status": "A",
        "authorized_official_last_name": "DYWER",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
        "authorized_official_telephone_number": "419-824-7334"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "OH",
            "license": null,
            "primary": true
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": "OH",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bay Park Surgical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oregon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.